Main Orthodontics Orthodontic treatment of retained teeth

Description Reasons Signs Consequences Treatment Prices Answers to questions

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Orthodontic treatment of retained teeth

We tell you what retained teeth are and how they are treated.

We use the most effective devices and advanced bite correction techniques

Treatment periods — from 2 years

Retention – is an eruption disorder that results in the tooth being located in the bone tissue of the jaw and hidden under the gum.

Retention can be complete or partial. In complete retention, the tooth is completely embedded in the bone tissue and is not present in the oral cavity. In partial – part of the crown is visible above the gingiva, but the final eruption does not occur. Partial retention is most often observed in third molars (wisdom teeth). In this case, the tooth is covered with dense mucosa, which is called «hood».

Retention of canines and wisdom teeth is most common, but any other tooth can be retained.

Why does retention occur?

Improper positioning of the rudiment of a permanent tooth.
Permanent teeth are located in the bone tissue above the temporary teeth of the same name. In some cases, as a result of intrauterine abnormalities or various diseases and traumas in the first years of life, the tooth beginnings may be misplaced or displaced. In this case, the tooth begins to grow and develop in the bone tissue of the jaw, but «find the way» to erupt it is much more difficult.

Presence of overcomplete teeth.
Supercomplex teeth – are «extra» teeth that should not normally be there. For example, «third premolar» on one side of the jaw. In such a case, only one of the teeth may erupt, and the second tooth will remain in the bone tissue as a result of lack of space./p>

Early loss of baby teeth.
With the early removal of temporary teeth (as a result of complicated caries or injuries), the displacement of adjacent baby teeth occurs and the loss of space for the eruption of a permanent tooth. In this case, dystopia of the tooth or its retention will be observed in a permanent bite.
When removing baby teeth, be sure to consult an orthodontist. An orthodontist will help you save space for a permanent tooth and you will avoid the formation of malocclusion and retention pathologies in a child.
Follicular cyst.
Such a cyst develops from the cells of the rudiment of the tooth while it is still in the bone tissue. The tooth may be partially located in the cyst cavity (crown only) or completely (crown and root). A tooth with a cyst loses the opportunity for eruption at its due date and becomes retarded.A cyst may not manifest itself for a long time, but infection and suppuration may occur at any moment. In order to prevent life-threatening conditions, when a cyst is detected, it is recommended not to delay treatment.

How to understand that there are retinated teeth?

If you are missing a tooth in your mouth, then there may be two options:

Adentia (the tooth is basically missing, its rudiment has not formed)
Retention (there is a tooth, but it has not erupted)

X-rays can help you understand the cause. The doctor will use the CT scan to determine the presence of the tooth in the bone tissue, its location, and the possibility of complications.

The presence of a retained tooth can be suspected as early as childhood. The baby teeth fall out one by one and are replaced by permanent teeth. If the temporary tooth does not loosen or the permanent tooth does not begin to grow after it falls out, we can assume either the absence of the rudiment of a permanent tooth or retention.

Retention in adulthood will result in the retention of a baby tooth or its absence from the tooth row. Neighboring teeth will most often be tilted or displaced into the area of the missing tooth.

At the same time, retention is more likely to occur in the area of the missing tooth.

But these are only indirect signs – only a doctor can confirm the presence of a retained tooth using CT scan data.

What are the risks of having a retained tooth?

A retrospective study based on CT scan data found that approximately 63.7% of retained teeth caused complications.

Among them were identified:

Periodontal bone loss (44.4%)
Root resorption (33.3%)
Cysts or tumors (8,6%)
Cavities (2,3%).

The most common cause of complications was mandibular third molars.

Source:

Sarica I, Derindag G, Kurtuldu E, Naralan ME, Caglayan F. A retrospective study: Do all impacted teeth cause pathology? Niger J Clin Pract. 2019 Apr;22(4):527-533. doi: 10.4103/njcp.njcp_563_18. PMID: 30975958.

What can be done with retained teeth?

Determining the «fate» of a retained tooth requires careful diagnosis and examination of the entire clinical picture. In order to make a decision, it is important to know:

Which tooth is retentive
How is the tooth located in the bone
Is there a place in the dentition for a retentive tooth
Does a retinated tooth cause any complications
Is there a malocclusion
How difficult is it to remove a retinated tooth

After gathering all the data and taking a comprehensive approach from the orthodontist and the dental surgeon, the treatment tactics may vary:

Observation

If there is no need for orthodontic treatment, the aesthetics of the smile is not impaired, the maxillary system functions correctly and the retented tooth does not cause complications, then it is necessary to monitor and regularly monitor the position and condition of the retented tooth.

Orthodontic treatment

Orthodontic traction includes a surgical stage - creating access to a retentive tooth.

During the surgical opening of the tooth, it is carried out:

Local anesthesia in the gum area above the retinated tooth
Excision of the mucosa
Fixing the button on the crown of a retented tooth
Fixation of orthodontic traction for traction.

Depending on the location, traction can be carried out in an open or closed method. In the open method, the mucosa is not sutured after opening and fixation of the orthodontic structure, in the closed method – a suture is applied and the button is placed under the mucosa until the tooth erupts.

After the tooth has been pulled, it must be properly positioned – the button is changed to a bracket and connected to the entire bracket system.

Orthodontic treatment with retention tooth extraction – it is a long and complex process with a treatment time of 2 years or more.

Removal

If orthodontic treatment is not indicated, but the retained tooth causes complications, it is necessary to remove it. For example, «eight» (wisdom tooth) when erupting can bring significant discomfort – begins to destroy the root of the neighboring tooth, inflamed gum above the tooth, etc.

Orthodontic extraction

If a retained tooth is causing complications and needs to be extracted, but it is deep and surgery to remove it would be too traumatic, orthodontic traction followed by tooth extraction can be utilized with minimal risks.

If you suspect that you have a retained tooth – do not delay your visit to the dentist. The orthodontists at «Konfidencia» will perform a thorough diagnosis and create a treatment plan for your clinical situation. Retained teeth for us – is an interesting challenge that we meet every day and we know how to solve it.

Leading orthodontist

Sigua Nino Valerievna

Retained tooth extraction — it is always quite a long and laborious process, but how awe-inspiring to see the appearance of a beautiful healthy tooth in the mouth, which takes its rightful place in the slender row «fellow teeth.».

Diagnostic consultation with a leading orthodontist